Houston federal court rejects insurer's claim denial

Gilberto Espinoza, an employee of Houston-based Defendant Becon Construction Company, died in an automobile accident in Kentucky. His blood alcohol levels showed he was legally intoxicated.  Life Insurance Company of North America denied his widow's claim for acidental death benefits.  The insurance company claimed the death was not an "accident" because it was not “a sudden, unforeseeable event."  In essence, the insurance company contended that because Espinoza “would have been aware of the risks involved in operating his vehicle while under the influence,"  his death was a foreseeable result of his actions and thus not an accident.

In a well-reasoned opinion, the Houston federal district court ruled against the insurance company and its attempt to craft a per se rule that driving while intoxicated is never an accident.  Had the insurance company wanted to enforce such an exlusion, it should have explicitly been stated in the policy.


Texas Accidental Life Insurance Lawyer